Circumcision or mutilation?

By Benjamin Bassham, News Editor

Surgically altering a girl’s genitals is a felony in the U.S., and illegal in most of the world, and taking a knife to anyone’s genitals without their consent is horrible. Perpetrating unnecessary surgery on children is always a repugnant act. That’s why it’s so odd that it’s not just legal for boys worldwide, but frequently encouraged by medical professionals.

The surgery has fallen out of official favor in Canada, the United Kingdom and Australia since the 1950s, except for religious reasons, after an article was published showing about 14 boys died from it in England each year. The prevalence of infant circumcision has declined in Canada to 9.2 percent according to the Canadian institute for health information, to under 11.7 percent for UK infants according to the British National Survey of Sexual Attitudes and Lifestyles, and Circumcision Information Australia says the rate of infant circumcision there is 10.8 percent. Although, the overall proportion of circumcised men is much higher due to past practice.

This leaves the U.S. the only industrialized country where circumcision is widely promoted for medical reasons.

The U.S. department of Health and Human Services says 1.1 million infant circumcisions were performed in the U.S. alone in 2008, affecting more than 60 percent of male births.

Most of these surgeries are performed in the first three days of life.

The World Health Organization says one third of men, globally, are circumcised — a billion flayed penises.

I think we should make very sure we’re doing the right thing here.

Death

Medical organizations brush aside the inevitable deaths that result from skinning millions of babies, saying medicine has improved enormously, making the procedure less likely to cause unintended, additional harm.

I’m delighted we’ve gotten so skilled at cutting pieces off of screaming children that it hardly ever kills them, but the rest of the world isn’t so talented. The Third World doesn’t have antibiotics or terrifying medical clamps and hole-punch devices for removing pieces of boys. They use the same unsanitary razor blades on boys that they use on girls.

Ryan McAllister, Ph.D. of Georgetown University, said, “We’re silent about the male genital cutting that occurs (under) the same conditions of hygiene and the same death rates.”

Even in the U.S., there are still over 100 deaths from circumcision each year. It is unknown how many die worldwide, but it is in the thousands, at least.

Infants are very fragile, and the consent forms parents are given downplay the risk involved. For instance the forms warn of “bleeding” as a consequence.

McAllister said, “Bleeding (is a) sort of minimizing term. It turns out an infant has 12 ounces of blood. Bleeding a couple ounces can cause death.”

Disease

The non-fatal consequences of medical penis pruning are what you’d expect: infection, necrosis, amputation, permanent disability and eye-watering deformity.

The infection in particular is no surprise. Imagine having to pee through a raw bloody wound, one that will marinate in urine and feces.

The wound remains painful for 7 to 10 days, requiring frequent bandage changes and ointment.

In contrast, an undamaged penis requires no maintenance. Just don’t screw with it.

David M. Gibbons, an associate professor of pediatric urology at the Georgetown University School of Medicine, said over a two-year period he was referred over 275 newborns and toddlers with complications from circumcision and 45 percent of them required a second surgery to correct the damage from the genital cutting.

In most places where it is common, like sub-Saharan Africa and Islamic countries, it is done to adolescents. This is still hideous, but better than peeling a newborn, before he even has his immune system up and running.

Double standard

“It appears the Hippocratic oath has been amended,” said Mike Stephenson, an artist who speaks on men’s rights issues, known on YouTube as DoctorRandomercam. He said, “It is now, ‘Do no harm — to girls.’ But you can amputate a boy’s skin with no anesthetic while he screams for his life, as long as the parents say it’s OK, when you recommend it to them as a medical professional.”

Circumcision is promoted on the cultural grounds that uncircumcised children won’t fit in with their fellows. This excuse fails immediately because if it applies to boys it applies to girls.

The WHO estimates that, worldwide, 200 million women alive today had their genitals cut, with degrees of severity ranging from token nicking and bloodletting to full infibulation. Circumcised women in the Third World frequently insist their daughters be cut too.

Is this OK with you?

Similarly, if male genital cutting is acceptable because it is less severe, sometimes true, depending on the amount of flesh to be removed, then parents should have the right to give their daughters genital piercings. That’s far less damaging than circumcision.

Pain

The pain of the surgery is excused saying, “They don’t remember it,” as though that absolves the cruelty of carving a newborn like a roast. Hey, can I hold your baby over a fire until its skin sizzles like bacon? They won’t remember it when they grow up, so that makes it OK.

I dare anyone who offers a defense for this barbarity to watch a video of a circumcision. A still picture of the inflamed bloody mess is bad enough, but just listen to that infant’s eerie, bone chilling scream. It isn’t like a baby’s normal cry. It is the sound of a helpless newborn’s unbearable pain. The first time I saw a video of this mutilation I noticed afterward that my right arm hurt because of the white-knuckled grip of my left hand’s fingers digging into it above the elbow.

I dare you to sit through that horror and then say, “This is a good thing. The world is a better place because this happened.”

If they don’t remember it, why do they have increased stress hormones for six months? Why does the infant’s brain show lasting trauma, and why do they have detectable cognitive damage later in life?

A study by Taddio, Katd, Ilersich and Koren, 1997, showed circumcised infants have a long-term aggravated response to pain, lasting at least six months.

Multiple studies have found that men circumcised in infancy experience symptoms of post-traumatic stress disorder, depression, anger and intimacy problems, according to Gregory J. Boyle, 2002; Ronald Goldman, 1999; and Tim Hammond, 1999.

Mild anesthetic is sometimes used, but according to the University of Alberta, up to 96 percent of babies in the U.S. and Canada receive no anesthesia at all. So when the doctor shoves a probe in and starts ripping the foreskin from the glans, babies feel every second of it.

A study, by Brady-Fryer, Weibe and Lander, 1997, tried to determine the best way to relieve circumcision pain but was aborted because the control group was in so much pain some of the infants began choking and vomiting. It was deemed unethical to perform standard circumcisions for the study.

For a fair comparison of how much that hurts, how would you like it if someone decided to slowly saw one of your fingertips off? Don’t worry; it won’t impair your ability to hold things. No, you don’t have any say in it. Now hold still so I can make a neat cut.

The circumcision restraint is an astoundingly ugly device. It’s a baby-sized torture rack. You don’t want that kid to start flopping around when you dig in with the scalpel, so the restraint binds all four limbs, leaving them helpless to do anything but scream while the doctor cuts and peels.

Loss

Enough side effects and blood, what are the actual intended results of circumcision?

Depending on the surgical technique, an adult penis loses 12-15 square inches of skin, and 20,000 nerve endings and specialized stretch receptors.

Also lost is most of the penis’ skin mobility and the male’s contribution to lubrication during sex, increasing the risk of micro-tears in the vagina, possibly increasing transmission of disease.

The first ever penile sensitivity study, by Morris L. Sorrells and others, 2007, revealed that nearly all pleasure-sensing nerves in the penis are on the foreskin. On cut men, most sexual sensation comes from whatever fragments of the foreskin were left after circumcision.

Paul Tardiff, who was circumcised at 30, said it is like “only being able to see in black and white, rather than seeing in full color. There are feelings you’ll just never have without the foreskin.”

In leaked audio from a panel at the 2013 Pitts Lectureship in Medical Ethics at the Medical University of South Carolina, Dr. Robert M. Sade of the Medical University of South Carolina, shared an anecdote about giving circumcisions to sailors during the Vietnam war as way to last longer, before orgasm, in bed.

He said, “They knew from evidence from their friends that having circumcision improves sex because you could last longer. You didn’t have the same degree of stimulation.

“The fact is; the reduction of sensation is very valuable to many men. “I think it’s beside the point to talk about loss of sensitive tissue.”

This contradicts the AAP’s public denial that there is any loss of sensation from male genital cutting.

Stephenson said, “Someone can decide for themselves that they want to have longer, perhaps even tantric sex. But doing it to someone else is to say you want them to last longer in bed —  a pretty sick thing to do to an adult, — but to do it to your son because you want them to last longer for someone else (is even sicker).”

Deception

Gregory Boyle’s study said the medieval rabbi Moses Maimonides, who lived from 1135 to 1204, said the explicit reason for circumcision was to reduce sexual gratification.

Genital cutting changed from a religious ritual to a popular medical practice by a path of scientific ignorance and superstition.

In Victorian times, and through the 1930s, it was thought that nervous excitation was the cause of disease, and sexual excitement was considered dangerous. All kinds of hideous, spiked metal and leather devices were manufactured to prevent children from masturbating, and circumcision was prescribed as an outright cure.

Athol A. W. Johnson said, “In cases of masturbation we must — cause too much local suffering to allow the practice,” in “The Lancet” in 1860.

Through the 19th century circumcision was touted to cure everything from epilepsy and asthma to clumsiness.

As science improved and the germ theory of disease caught on better, more modern reasons to skin an infant had to be developed.

For instance, the 2012 American Academy of Pediatrics Report on Circumcision says cutting off a chunk of a penis prevents it from developing cancer later.

The American Cancer Society, however, says it does not protect from penile cancer, and has expressly asked the AAP in 1996 to stop promoting circumcision for prevention of any cancer, saying, “Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate”

The rate of penile cancer is less than 1 in 100,000, about 10 percent of the average rate of death from circumcision. Breast cancer by contrast affects one in eight women. By the AAP’s logic, infant girls’ breast tissue should be cut away.

A study, intended to show the surgery prevents HIV, was run with three randomized trials in Africa. “Probably because you couldn’t get a human review board to permit such a study in the U.S.,” McAllister said.

Published by Bertran Auvert and others, 2005, the study gathered volunteers, randomly circumcised half, and waited to see who developed HIV. Participants were paid about $40 in local currency for gambling with their health.

The study’s methodology was pathetic.

The subjects were given condoms and safe sex counseling at each visit, and the circumcised men visited at least twice more, for surgery and follow up.

Then after surgery the cut group was asked to wait six weeks before having sex, but the study began immediately, while they were still recovering. And the antibody test they used to detect HIV has a three-month delay before infection is detectable.

There were other flaws, but each of these three alone is sufficient to invalidate the study.

The Auvert study says, “Male circumcision provides a degree of protection against HIV equivalent to what a vaccine of high efficacy would have achieved.” They claim a 60 percent decrease in female to male infection.

No claim was made of male to female infection, presumably because they knew how bad the results would be.

One trial in Uganda had to end early after it found the male to female transmission was too high, higher than for intact men. This could be because telling people that they are immune to HIV will cause them to engage in unsafe sex.

This study is used by the WHO to promote the virtues of circumcision.

Even if the findings were true, is that enough protection to make condoms unnecessary?

For comparison the measles vaccine yields 99 percent immunity. And that’s for life, not per exposure, and for both sexes.

McAlister said all other studies disagree with the Auvert study. The U.S. has highest circumcision rate of any industrialized nation and highest HIV rate of any industrialized nation. In fact, most areas that practice circumcision have higher rates of HIV infection.

A study by Wiswell and Geschke, 1986, started the popular myth that circumcision prevents urinary tract infections (UTIs).

In addition to other errors, Wiswell instructed parents to forcibly retract their infants’ foreskins and wash under them.

In infants the foreskin is bonded to glans to protect from waste. McAllister said tearing it loose this way creates a site for infection. Wiswell’s methodology was creating UTIs in healthy boys.

Even if Wiswell were correct, UTIs in men are so rare that 50 to 100 boys must be bloodily trimmed to prevent one infection.

And again, UTIs are more common in women. Should we start cutting parts off of them now?

Stephenson said jokingly, “The foreskin evolved over millions of years, but that doesn’t mean it evolved for a beneficial reason. Unlike all the other parts of the skin which have evolved specifically to prevent as many infections as possible, the foreskin is the one part of the human epidermis which, in fact, facilitates as many infections as possible.”

He said, “That is an extraordinary claim, don’t you think?”

The foreskin is badly misunderstood, perhaps especially by doctors.

McAllister said the foreskin is missing from most U.S. anatomy texts, with only the cut penis shown, and no education provided about its function.

Doctors are only taught how to remove it, or mistaught about washing under the foreskin.

Misdiagnosis of phismosis, a condition where the opening in the foreskin is too small, is extremely common. The foreskin has to separate from the glans in its own in time, and phismosis cannot be diagnosed in infancy, but doctors are trained to treat normal physiology as a justification for circumcision.

Even in actual phismosis, steroidal creams often solve the problem better than surgery.

McAllister said doctors who do stand against circumcision can have a rough time of it, giving as examples; Marilyn Milos, a registered nurse, and later the founder of the National Organization of Circumcision Resource Centers, who was fired in 1985 for telling parents it was painful and unnecessary.

Similarly, Dr. Michelle Storms said, “I have been ridiculed, patronized, ostracized — for my refusal to perform — circumcision.”

Profit

McAllister said parental consent to all this is based on little or false information, and the question is flung at mothers that have just been in labor.

“They are also asked about it in this sort of values neutral way. Would you like a pillow? Would you like a cup of tea? Would you like your child circumcised?”

He calls it “manufacturing pseudo-informed consent.”

“There is also this undeclared conflict of interest. There is really a lot of commercial use of the tissue,” he said.

If a starlet’s lips look fuller than they used to, it might be because they’re full of cultured tissue from baby foreskins.

The harvested baby flesh is used for “magic skin” treatments and cosmetics, like SkinMedica, as promoted by Oprah Winfrey, and it’s used to produce collagen for cosmetic surgery. It’s a profitable business, with a single foreskin selling for thousands of dollars. That’s why lobbyists for the mutilated baby penis industry like to hire, or pose as, scientists and doctors to promote it.

McAllister said, “If you’re disturbed by that I’m glad, because I’d like us to be disturbed by it.”